Provider Demographics
NPI:1841621299
Name:CHRISTIAN GLOBAL MEDICAL HEALTHCARE, INCORPORATED
Entity type:Organization
Organization Name:CHRISTIAN GLOBAL MEDICAL HEALTHCARE, INCORPORATED
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CHIEF GLOBAL EXECUTIVE OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:MANJERNGIE
Authorized Official - Middle Name:CECELIA
Authorized Official - Last Name:NDEBE
Authorized Official - Suffix:
Authorized Official - Credentials:RN, FNP-C, PHD
Authorized Official - Phone:269-352-0655
Mailing Address - Street 1:PO BOX 497
Mailing Address - Street 2:
Mailing Address - City:PORTAGE
Mailing Address - State:MI
Mailing Address - Zip Code:49081-0497
Mailing Address - Country:US
Mailing Address - Phone:269-352-0655
Mailing Address - Fax:
Practice Address - Street 1:451 W MILHAM AVE
Practice Address - Street 2:
Practice Address - City:PORTAGE
Practice Address - State:MI
Practice Address - Zip Code:49024-2721
Practice Address - Country:US
Practice Address - Phone:269-352-0655
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-12-11
Last Update Date:2013-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI261QU0200X
261QP2300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QP2300XAmbulatory Health Care FacilitiesClinic/CenterPrimary Care
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent Care